Tinea Cruris Research Articles

Comparison of patterns of male genital dermatoses in HIV seropositive versus seronegative individuals – An observational study from North India

Abstract Background: Venereal and nonvenereal genital dermatoses at times tend to appear similar creating confusion while diagnosing. This may be a matter of considerable concern to the patients and may cause diagnostic dilemma to the treating physician. Since HIV infection significantly escalates the likelihood of contracting another sexually transmitted pathogen, these infections are commonly assumed to be venereal in nature. However, after the advent of effective anti-retroviral therapy, increase in the lifespan of HIV-positive population has been observed which has led to the inclusion of nonvenereal genital dermatoses as well. However, there is a paucity of data comparing the pattern of various genital dermatoses in seropositive and seronegative patients. The aim of our study was to compare the pattern of various venereal and nonvenereal genital dermatological conditions in seropositive and seronegative male patients. Materials and Methods: We enrolled all male patients in the age group of 0–80 years. A detailed history was obtained and clinical examination was done, along with relevant investigations as per the requirement to reach the final diagnosis. Results: A total of 802 cases were enrolled in the study. Out of these, nonvenereal dermatoses constituted 492 (61.3%) and venereal dermatoses had 310 (38.7%) cases. HIV seropositivity was found in 47 cases (5.86%). There were 6.77% cases of venereal dermatoses and 5.28% cases of nonvenereal dermatoses in HIV-positive patients in our study. Among the 47 HIV-positive males with genital dermatoses, herpes genitalis was found to be the most common venereal disease which constituted 11 cases (23.40%). Other cases included genital warts (14.89%), genital molluscum contagiosum (4.25%), and syphilis (2.12%). Among the nonvenereal diseases in HIV-positive males, Tinea cruris was the most common, affecting 29.78% of cases, followed by scabies (21.27%), candidal balanoposthitis (2.12%), and lichen simplex chronicus (2.12%). In HIV-negative patients, genital warts (41.18%) were the most commonly found venereal disease among others and scabies (26.39%) was the most common nonvenereal genital disease. Conclusion: From our study, it was concluded that nonvenereal genital dermatoses were more in number as compared to venereal dermatoses in both HIV-positive and HIV-negative males. This study was valuable for understanding the epidemiological, clinical, and etiological characteristics of various genital skin conditions, both venereal and nonvenereal, and comparing them between HIV-positive and HIV-negative groups.

Clinicomycological Profile of Dermatophytosis in a Tertiary Care Hospital in Tamil Nadu, India.

Background Dermatophytosis, a prevalent superficial fungal infection, has emerged as a significant public health concern in India, warranting comprehensive investigations to understand its clinicomycological profile. This study aimed to analyze the demographic, clinical, and mycological patterns of dermatophytosis in patients attending a tertiary care center in Tamil Nadu, with a particular focus on species identification given the changing epidemiology and emerging antifungal resistance in the region. Methodology This cross-sectional study included 194 clinically diagnosed dermatophytosis cases visiting the Dermatology Outpatient Department from March 2022 to February 2023. Socio-demographic data, clinical presentations, and laboratory findings were recorded. Samples, including skin scrapings, nail clippings, and epilated hair, were collected by dermatologists and processed by trained laboratory technicians. Fungal isolates were identified based on colony morphology and microscopic characteristics. Results The study population comprised 112 (57.7%) males and 82 (42.3%) females. The predominant age group was 21-30 years old, observed in 59 (30.4%) cases. Acute presentations (<1 month) were most frequent with 92 (47.4%) cases, followed by chronic cases (>3 months) with 63 (32.5%) cases. Family members were the primary source of infection in 56 (28.9%) cases. Laboratory analysis revealed potassium hydroxide (KOH) positivity in 148 (76.3%) cases and culture positivity in 169 (87.1%) cases. Tinea corporis was the predominant clinical presentation, with 114 (58.7%) cases, followed by tinea cruris, with 39 (20.1%) cases. Risk factor analysis identified male gender (OR: 1.86, 95% CI: 1.24-2.78), family contact (OR: 2.34, 95% CI: 1.52-3.60), age >20 years (OR: 1.67, 95% CI: 1.12-2.49), and duration >3 months (OR: 1.93, 95% CI: 1.28-2.91) as significant risk factors. Mycological analysis revealed Trichophyton mentagrophytes as the predominant species with 149 (76.8%) isolates, followed by T. rubrum with 35 (18.0%) isolates. Conclusion This study elucidates the clinicomycological profile of dermatophytosis in a tertiary care setting in Tamil Nadu, India, highlighting the predominance of Trichophyton mentagrophytes as the primary etiological agent. The ascendancy of T. mentagrophytes warrants clinical vigilance, given its established association with terbinafine resistance and chronic dermatophytosis across the Indian subcontinent. These findings underscore the imperative of accurate species identification to facilitate evidence-based antifungal selection, potentially mitigating therapeutic failures and recalcitrant infections.

An IoT-Driven Real-Time Skin Disease Detection System using Machine Learning

Approximately 900 million individuals globally are said to have diseases associated with the skin, thus becoming one of the prevalent diseases in the world. Common conditions in southern Punjab are acne, psoriasis, and fungal infections. Eczema has associated red tones and is usually marked by dryness and itchiness. Psoriasis creates reddish patches due to the scale formation and the occurrence of thick patches. There are common forms of fungi infections known as ringworm and jock itch and mostly fungi are favored when in a warm and damp environment. Only through quick detection and treatment can one prevent critical cases of skin problems. Skin diseases prove difficult to diagnose because every skin is different in either the types or textures they hold. Researchers have recommended various early detection methods for them. Their solutions through a range of machine learning algorithms like random forest, naive Bayes, logistic regression, kernel SVM, KNN, and CNN based on which they used detection methods for various skin diseases. Based on the detailed research, the real-time symptoms from an IoT and machine learning model can diagnose the skin diseases. Cameras will take pictures of the skin images. IoT will measure body temperature, and a deep learning algorithm and CNN algorithm predict the diseases. The output is provided on the GUI as an Android application, in order to help them understand whether they have skin diseases and allergies early.

Clinico-Mycological Profile of Dermatophytic Skin Infection: Cross Section Study

Background: Dermatophytoses, commonly known as “ringworm”, are superficial fungal infections that affect the skin, hair, and nails. Objective: To evaluate the clinical features of dermatophyte infection and identify the causative fungal species by direct microscopic examination and mycological culture. Methods: The study was conducted over one year and included patients of both sexes and different ages. Scrapings were taken from skin, hair, and nails. Collected samples were subjected to KOH 10% to detect fungal elements. Additionally, mycological cultures were performed on modified Sabouraud’s dextrose liquid media incubated at room temperature for 1 to 6 weeks, then examined microscopically to identify fungi at the species level. Results: In this study, a total of 100 patients were included, with a mean age of 30.29 ± 16.00 years. Fifty-six percent (56%) of the patients were female, and sixty-two percent (62%) of the patients resided in urban areas. T. corporis was observed in forty-six patients (46.0%), followed by T. cruris, which was present in twenty-three patients. The majority of patients (85.0%) presented with a non/ minimal inflammatory type. Trichophyton rubrum was the most commonly found, accounting for thirty-three cases (45.8%), this was followed by Epidermophyton floccosum (26.3%) and Trichophyton mentagrophytes (16.7%). The majority of tinea corporis cases were caused by Trichophyton rubrum, while tinea cruris cases were mostly caused by Epidermophyton floccosum. It was noted that most cases of Trichophyton rubrum and Epidermophyton floccosum presented with a non/ minimal inflammatory character. Microsporum gallinae, a species rarely isolated in our country, was presented in two patients with tinea capitis in this study, accounting for 2.8% of cases. Conclusion: Trichophyton rubrum an anthropophilic fungi was the most common isolated species. Anthropophilic infections are often epidemic in nature. Therefore, implementing preventive measures is crucial to restrict spread of infection.

A real-world retrospective study to determine the safety and effectiveness of naftifine 2% cream in the treatment of Tinea cruris and Tinea corporis in Indian patients

Background: This real-world retrospective analysis of the case record forms (CRFs) was done to evaluate the safety, effectiveness, compliance, and tolerability of naftifine 2% cream in treating superficial infections, especially Tinea corporis and Tinea cruris, in Indian patients. Methods: The data was collected from 158 dermatologists/physicians’ outpatient department in India, on using naftifine 2% cream in patients presenting with new or recurrent Tinea infections. The CRFs of 1258 patients who had previously visited the dermatology outpatient department from July 2023 to May 2024 and received naftifine 2% cream as monotherapy or in combination therapy at the discretion of the treating physician were included in the study. Results: A total of 1,258 eligible CRFs were analyzed, revealing that 81% of patients treated with naftifine 2% cream achieved clinical cure, while 99.6% achieved mycological cure. Adverse events were reported in only 2.6% (n=33) of patients, and naftifine 2% cream treatment was well tolerated. Conclusions: This retrospective study suggests that naftifine 2% cream is safe and effective in patients with superficial fungal infections, including Tinea corporis and Tinea cruris.

Clinical Patterns of Superficial Fungal Infections in Children Attending Outpatient Department of a Tertiary Hospital in Bangladesh

Superficial fungal infections (SFIs) are common skin infections worldwide. These infections significantly affect the health and well-being of children, particularly in a developing country like Bangladesh. Therefore, there is need to provide up-to-date information on this disease for evidence based effective interventions. The aim of the present study was to determine clinical patterns of superficial fungal infections in children attending the outpatient department of Dermatology and Venereology of Mugda Medical College Hospital, Dhaka, Bangladesh. This cross-sectional, descriptive study was conducted from January to June of 2024. A total of 385 children aged £18 years with superficial fungal infections were included in this study. Demographic data, medical history and systemic disease were documented. 10% potassium hydroxide microscopy and Wood’s lamp examination were done when necessary. The groin was the most frequently affected site (41.8%), followed abdomen (24.9%), limbs (23.4%) and face (22.1%). Tinea corporis is the most prevalent type of superficial fungal infections (57.7%), followed by tinea cruris (42.9%), tinea faciei (20.5%), and tinea capitis (16.6%). Tinea capitis, tinea faciei, and cutaneous candidiasis were more prevalent in 0-6 years age group, while tinea corporis, and tinea cruris were more prevalent in 13-18 years age group; the differences were statistically significant (P&lt;0.05). Tinea capitis and pityriasis versicolor were found significantly prevalent in males in comparison to females (P&lt;0.05). Mugda Med Coll J. 2024; 7(2): 114-118

A Comparative Evaluation of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) and Conventional Methods for the Diagnosis of Dermatophytes.

Background and objective Dermatophytosis refers to superficial skin fungal infectionin humans. The laboratory diagnosis of thepathogens causing dermatophytosis is challenging.In recent years, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has emerged as an effective tool for diagnosing and identifying microorganisms. This study aimed to compare MALDI-TOF MS with conventional methods of identification to assess the existing knowledge on the diagnostic capabilities of MALDI-TOF MS for dermatophyte infections. The findings of this study have significant implications for clinical practice, public health, and future research endeavors in dermatophytosis diagnostics. Methods This prospective study was conducted in the Post Graduate Department of Microbiology at a tertiary-level teaching Medical University over 12 months, from January 1, 2020, to December 31, 2020. A total of 138 clinical cases among the patients attending the skin OPDwith clinical features suggesting fungal skin infections were included. Conventional methods such as microscopy, slide culture, biochemical tests, and culture on Sabouraud dextrose agar(SDA) were used as the reference standard for species identification. ATCC (American Type Culture Collection)strains of dermatophytes were used for quality control. The MALDI-TOF Vitek MS (BioMerieux, Craponne, France) system was employed for comparison, and the agreement between the two methods was determined. Results Of the 138 samples, 89 were from males and 49 from females. The majority were taken from the skin (103, 75%) samples followed by nails (30, 21%) and hair (5, 4%). Tinea corporis was the most common clinical type, seen in 81 cases (58.70%), followed by onychomycosis seen in 30 (21.74%) cases, and tinea cruris seen in 16 (11.59%) cases. The most prevalent isolate discovered in tinea corporis was Trichophyton tonsurans (T. tonsurans), followed by Trichophyton mentagrophytes (T. mentagrophytes). Traditional methods and MALDI-TOF MS (Vitek MS) had 100% agreement for T. tonsurans, Trichophyton rubrum (T. rubrum), and Microsporumgypseum (M. gypseum). However, there was disagreement between T. mentagrophytes and Trichophyton interdigitale (T. interdigitale), which had 0.00% agreement. Conclusions Our research showed that no single diagnostic approach would be optimal for every situation that was examined. However, traditional procedures remain the most dependable and efficient methods for mycological diagnostics. However, MALDI-TOF identification results are available much earlier than those of traditional methods.

Terbinafine-Resistant Dermatophytes Isolated in Japan.

An epidemiological study of terbinafine (TBF)-resistant dermatophytes was conducted in 2023 as a follow-up to our 2020 and 2022 surveys. Dermatophytes were isolated in 2023 from the same dermatology clinics in Tokyo, Saitama, Shizuoka, and Kumamoto, Japan, as in the previous studies. In total, 311 isolates (122 Trichophyton interdigitale isolates, 1 Trichophyton indotineae isolate, and 188 Trichophyton rubrum isolates) were obtained from 311 human cases of dermatophytosis (195 tinea pedis cases, 54 tinea unguium cases, 28 tinea corporis cases, 27 tinea cruris cases, and 7 tinea manuum cases). Ten strains (1 T. interdigitale strain and 9 T. rubrum strains) were found to be resistant to TBF, and susceptible to efinaconazole, itraconazole, luliconazole, and ravuconazole. The isolation rate of TBF-resistant strains was 2.3% in 2020, 1.4% in 2022, and 3.2% in 2023. We determined the sequences of the squalene epoxidase-encoding gene in 10 TBF-resistant strains, and found that all strains harbored missense and/or deletion mutations. These results indicate that the prevalence of TBF-resistant dermatophytes has increased when compared to the previous studies.

Comparison between oral voriconazole and terbinafine in treatment of relapse or resistant tinea corporis and cruris

Comparison between oral voriconazole and terbinafine in treatment of relapse or resistant tinea corporis and cruris

P-1020. Randomized control trial to study the effectiveness of tablet Fluconazole, capsule Itraconazole and tablet Terbinafine in superficial dermatophytosis

Abstract Background According to the World Health Organization, dermatophytosis is a relatively frequent superficial fungal infection of the keratinizing structures of the body with a prevalence of 20% - 25% worldwide. The organism is more widespread in tropical areas, with India acting as the main infection hub, because it prefers a hot and humid climate. Tinea corporis is the most common kind of superficial dermatophytic infection, second most common is tinea cruris followed by tinea capitis, tinea unguium, tinea faciei, tinea manuum and tinea pedis. Hot, humid weather, overcrowding, poverty, poor cleanliness, lack of health-care facilities, immunosuppression, and irrational drug use are all risk factors for dermatophytosis. Fungal skin infection responding to Oral Itraconazole Clinical response of Dermatophyte infection to Oral Itraconazole at 4 and 8 weeks as compared to baseline Methods Total of 180 patients were included in the study and divided into 3 groups based on the day of visit to the hospital and antifungals Fluconazolee, itraconazole or Terbinafine were randomly prescribed to them (60 patients in each group). Patients were followed up at 4th and 8th week for therapy response. Results At the end of 8th week KOH (Potassium hydroxide) mount was found to be negative in 86.67%, 73.33% and 63.33% among Itraconazole Fluconazole and Terbinafine groups respectively which was highly significant. Conclusion Dermatophytosis is comparatively more commonly seen in physically active age group. Clinical features waned off quicker and better with Itraconazole in comparison to Fluconazole and Terbinafine. Again fluconazole was found to be yielding better clinical outcome than Terbinafine. Overall outcome of patients with dermatophytosis was found to be more satisfactory with a 4 week oral dose of itraconazole. So from this study we conclude that Itraconazole is a better choice of drug for Dermatophytosis compared to Fluconazole and Terbinafine. Also fluconazole is comparatively a better choice than Terbinafine for the same. Disclosures All Authors: No reported disclosures

Hubungan Tingkat Pengetahuan, Personal Hygiene dan Lingkungan Rumah terhadap Kejadian Tinea pada Nelayan di Kecamatan Kalianda

Tinea is a dermatophyte infection identified in 52% of incidences in the archipelago, with the highest prevalence of tinea inguinalis and tinea corporalis. Coastal workers, especially fishermen who are active in the aquatic environment, have a high predisposition to tinea due to a lifestyle that is negligent to hygiene, high humidity levels, tropical ambient temperatures, the use of damp clothing, accumulation of sweat, and dermal friction that accelerates the proliferation of mycoses. This study aims to evaluate the correlation between the level of cognition, personal hygiene, and domicile conditions to the incidence of tinea among fishermen in Kalianda sub-district. This analytic observational study with a cross-sectional approach involved 44 fishermen respondents who were taken through a simple random method. Data collection included questionnaire survey, clinical examination, and supporting investigation, with statistical analysis using chi-square test. Findings showed that limited cognition increased the probability of tinea by 5-fold, while poor personal sanitation increased the probability by 3-fold. Furthermore, inadequate housing conditions increased the risk by 2-fold. Therefore, the level of knowledge, personal hygiene, as well as the quality of the living environment significantly contributed to the prevalence of tinea in fishermen.

Comprehensive Review on Tinea Infection Therapies: Allopathic and Herbal Approaches for Dermatophytosis.

Tinea infections are superficial fungal infections caused by three species of fungi (i.e. Epidermophyton, Microsporum, and Trichophyton) collectively termed dermatophytes. Dermatophytes are fungi that cause skin, nail bed, and hair infections. These infections are classified based on infection site, including tinea pedis (foot), tinea corporis (body), tinea capitis (head), and tinea cruris (groin). Dermatophytes can spread by direct contact with other people (anthropophilic organisms), animals (zoophilic organisms), and soil (geophilic organisms), as well as indirectly from fomities. This review aims to summarize the allopathic drugs along with their mechanism of action and herbal drugs including their parts of the plant used for the treatment of tinea infections. The literature review was performed using the following databases: PubMed (https://pubmed.ncbi.nlm.nih.gov/), and Google Scholar (https://scholar.google.com/), to identify the various drugs involved in the treatment of dermatophytosis along with their mechanisms. The following keywords were applied in the search strategy: "Tinea", "Dermatophytosis", "Ringworm infection", "Pathogenesis of tinea", "Tinea pedis", and "Tinea capitis". This article also reviews several formulations that are available in the market for treating ringworm infection. The current review provides information about the classification of dermatophytosis based on infection site and environmental habitat, pathogenesis, immunopathogenesis of dermatophytes, and herbals and allopathic drugs used for their treatment.

The burden of cutaneous fungal infections in a tertiary care hospital in Pakistan.

In Pakistan, the real extent of fungal infection is unknown. Our objective was to estimate the burden of major fungal diseases here to emphasize their public health importance. In this retrospective study, the medical records (January 2019 - December 2019) of 863 patients diagnosed with superficial fungal infection (SFI) were reviewed at the dermatology department of Aga Khan University Hospital (AKUH) Karachi. Stata 17.0 was used to analyze the data. Chi-squared test or Fisher's exact test was used to evaluate association between variables. Descriptive analyses include means, frequencies, standard deviations, and percentage tests whereas Poisson regression with robust standard error was used to examine the association of age, gender, diabetes, and type of SFI with recurrence of SFI. In this study, the most common SFI was tinea cruris (234/863, 27.1%) in men (n=62, 21.7%) and females (n=172, 29.8%) followed by pityriasis versicolor (n=77, 26.9%) in males and tinea corporis (n=115, 19.9%) in females. Tinea cruris recurrence rates were similar between males and females (34/234, 14.5%). These findings show that fungal infections are a public health problem in Pakistan and that additional research is needed to assess their frequency in the general population. Clinicians must be taught and made aware of these infections to enhance diagnosis and treatment.

Clinical Patterns and Demographic Characteristics of Dermatophytosis in Surabaya

Dermatophytosis, the most common fungal infection in humans, significantly impacts quality of life due to its clinical and cosmetic effects. Its high prevalence underscores the need to evaluate patient profiles to improve management strategies. This study aim is to identify the most prevalent type of dermatophytosis, patient demographics, clinical characteristics, laboratory investigations, and therapy in dermatophytosis into the clinical and epidemiological characteristics of dermatophytosis in a tropical, high-burden region. This descriptive retrospective study used total sampling of medical records of dermatophytosis patients from January 2017 to December 2022. Tinea corporis and tinea cruris was the most common, while tinea manuum is the least common dermatophytosis. Female adults were the most affected group. Common clinical features for each type included alopecia for tinea capitis, erythematous macules for other types, and nail dystrophy for tinea unguium. Trichophyton mentagrophytes was the commonest pathogen in 2017. Most of the therapies followed Clinical Practice Guidelines with extensive use of griseofulvin and ketoconazole cream. Further research should explore therapeutic outcomes, preventive measures, and factors influencing recurrence and adherence to treatment.

Homoeopathy in the treatment of tinea cruris and tinea corporis – A case series

Homoeopathy in the treatment of tinea cruris and tinea corporis – A case series

An open label, single arm, pilot study to evaluate the safety, tolerability, and efficacy of daily fluconazole 150 mg in subjects suffering from Tinea cruris and Tinea corporis

Background Dermatophytes are the most common superficial fungal infections worldwide and are treated with prescribed regimens of terbinafine and itraconazole, or with weekly doses of fluconazole. Dermatologists are increasingly encountering treatment failures, and experts suggest that standard treatment regimens are not applicable anymore. We planned an open-label study to evaluate the results of fluconazole 150 mg daily for 8 weeks in patients with tinea cruris and tinea corporis. Methods Patients were enrolled from the La’Mer Clinic, Mumbai, India. We included adult subjects with uncomplicated dermatophytosis confirmed by microscopic examination of skin scrapings. Pregnancy, poor renal function, and recent exposure to anti-fungal therapy were exclusion criteria. Patients were reviewed on days 14, 28 and 56. The treating doctor scored the severity of erythema, scaling, and pruritus on a four-point scale: absent, mild, moderate, and severe. Of 107 subjects screened, 100 were finally included in the study. Eleven were lost to follow up and one subject withdrew consent. Results The site of disease was body alone in 29, groin alone in 7, and both body and groin in 64 cases. At 5 weeks, 98%, 100%, and 97% of patients had no scaling, erythema, and pruritus, respectively. Skin scrapings showed 100% mycological cure. In one patient the alanine transaminase level rose from 54.9 to 100.2 U/L, and qualified as a grade 1 adverse event not requiring intervention. No other significant adverse events were noted. Conclusions Our results suggest that fluconazole 150 mg daily for eight weeks effectively treats dermatophytosis. This regimen is safe and well-tolerated even in patients with co-morbidities. Fluconazole is about eight times less expensive than itraconazole or terbinafine and may be the preferred therapy. Registration The trial was registered with Clinical Trials Registry, India (Registration number CTRI/2020/06/026110) on 24 June 2020. FDC Company, India, provided financial support for the study.

Assessment and Management of Dermatological Issues in Hospitalized Geriatric Patients: A Retrospective Study in a Tertiary Care Hospital.

Skin problems, typically overlooked in elderly patients hospitalized for systemic diseases, can no longer be ignored. This study aimed to investigate the presence and management of dermatological problems in hospitalized elderly patients. This retrospective study involved dermatology consultations for 712 elderly patients (aged ≥ 65 years) hospitalized between October 2022 and October 2023. The departments that requested the most consultations were physical therapy and rehabilitation (n = 108, 15.2%), internal medicine (n = 64, 9%), and pulmonary disease (n = 52, 7.3%). Consultations were most frequently requested between the seventh and 14th day of hospitalization. The most common reasons for consultation were dermatitis (n = 185; 26%), fungal infections (n = 164; 23%), bacterial infections (n = 54; 7.6%), cutaneous drug reactions (n = 45; 6.3%), and viral infections (n = 44; 6.2%). The most common dermatological diagnoses were xerotic eczema, maculopapular drug eruptions, tinea cruris, tinea ungium, tinea pedis, contact dermatitis, cellulitis, shingles, and xerosis cutis. These results underscore the importance of convenient access to outpatient services for elderly patients and the need for primary healthcare facilities to have staff trained in geriatric dermatology to ensure optimal care for the aging population.

Comparison of Efficacy of Luliconazole 1% w/w Cream Versus Amorolfine 0.25% w/w Cream in the Treatment of Tinea cruris: A Single-center, Randomized, Double-blind, Non-inferiority Study

Dermatophytosis is a superficial fungal infection involving the keratinized tissues. Limited dermatophytosis is usually treated with topical antifungals. Amorolfine and luliconazole are relatively newer and superior topical antifungals much in use in recent times. To study the therapeutic efficacy and safety of luliconazole 1% and amorolfine 0.25% cream in patients with tinea cruris. A single-center, randomized, double-blind, non-inferiority study comparing luliconazole and amorolfine was conducted on patients with localized tinea cruris. 81 patients completed the study, with 40 patients treated with luliconazole and 41 patients treated with amorolfine. Both groups of patients were followed up at the end of 2 weeks. No statistically significant difference was found between luliconazole and amorolfine regarding improvement in erythema, scaling, pruritus, and mycological cure. Both the medications were safe and well tolerated by the patients. The duration of the study was short, and there was no long-term follow-up. Amorolfine is not inferior to luliconazole in treating limited tinea cruris.

Dermoscopic Features of Diaper Dermatoses in Children: A Descriptive Pilot Study.

Diaper dermatoses broadly refer to skin disorders that occur in the diaper area. Dermoscopy is a non-invasive diagnostic tool that magnifies subsurface structures of the skin that are invisible to the unaided eye. To identify and describe the dermoscopic features of dermatoses in the diaper area. A cross-sectional clinical study was conducted, which included 100 children below five years of age with dermatoses in the diaper area. The lesions were initially observed clinically and then under a dermoscope (Dermlite 4, 3GEN Inc., San Juan Capistrano, CA, USA). Findings were recorded and photographed. Of the 100 enrolled children, infectious dermatoses were observed in 46 cases, predominantly comprising scabies and tinea cruris, followed by intertrigo, molluscum contagiosum, and varicella. The most common dermoscopic feature of scabies was a jet wing with a contrail, whereas scaling, red-brown, and grey-brown dots and globules were observed in tinea cruris. Of the non-infectious dermatoses, contact dermatitis and vitiligo were the most common. Dermoscopy revealed irregular-dotted vessels and white structureless areas in cases of contact dermatitis. An absent pigment network and white structureless areas with leukotrichia and white glow were seen in vitiligo, which helped differentiate it from nevus depigmentosus. Single-center study with a limited sample size for each condition and histopathological confirmation could not be performed. This study highlights the dermoscopic features of diaper dermatoses and demonstrates the potential of dermoscopy to enhance diagnostic accuracy and optimize patient care without invasive investigations, underscoring its unique role in pediatric dermatology.

Dermatophytes: Update on Clinical Epidemiology and Treatment.

Dermatophytes represent the largest and most common group of fungal infections, impacting 25% of the global population. Among them, Trichophyton rubrum has emerged as the predominant species, responsible for a range of conditions such as tinea corporis, tinea pedis, onychomycosis, tinea cruris, and tinea manuum. Although dermatophyte incidence varies geographically, there is a noticeable rise in cases caused by T. indotineae, a strain that exhibits resistance to terbinafine. In the past decade zoophilic dermatophyte T. mentagophytes genotype VII (now known as T. interdigitale) gains a growing importance, due to its increasing frequency, the severity of the clinical manifestation and mode of transmission. Tinea infections present with various clinical symptoms and can affect individuals of all ages, from tinea pedis in adults to tinea capitis in children. Among adults globally, tinea unguium (onychomycosis) is the most common form of dermatophytosis, affecting 5.5% of the general population. Tinea unguium is more frequently seen in developed countries, while tinea capitis is more common in developing nations. The COVID-19 pandemic has led to an increase in cases of tinea faciei, likely due to prolonged mask-wearing. Terbinafine remains the preferred treatment for dermatophyte infections worldwide due to its potent fungicidal properties, minimal risk of drug interactions, and fewer side effects compared to other oral antifungals. Itraconazole and terbinafine appear to be equally effective and safe for treating tinea cruris and tinea corporis. However, the rising resistance of dermatophytes to these antifungal drugs, along with frequent recurrences of dermatophytosis in certain regions, is becoming a significant public health concern.